Senate GOP leaders will present health bill this week

WASHINGTON - After weeks of secret deliberations, Senate Republicans are in the final stages of a sweeping rewrite of the nation's health-care laws amid frustration among the rank and file over how to fulfill the party's top campaign promise over the past seven years.

Senate Majority Leader Mitch McConnell, R-Ky., said Tuesday that GOP leaders will produce a "discussion draft" on Thursday and hinted that a final vote could come next week - even as key senators expressed concern about the emerging legislation, the lack of transparency surrounding it and the disagreement that remains.

McConnell's desire to wrap up before the Fourth of July recess reflects the sense of urgency among Republicans, including President Donald Trump, to show progress on health care after years of vowing to "repeal and replace" the Affordable Care Act.

But McConnell's strategy for achieving that goal - writing a bill with a handful of aides behind closed doors - has come at a cost that reached new heights on Tuesday: anger among Republicans who feel shut out of the process.

McConnell told reporters that he would "lay out a discussion draft Thursday morning; you'll be able to take a look at it" - but he declined to discuss the specifics. He said the Senate would take up the bill on the floor once it receives a score from the nonpartisan Congressional Budget Office - possibly Monday.

Trump has sent mixed signals to Capitol Hill and has played a more hands-off role in Senate deliberations than he did in the House. While the president has pushed for swift action on health care and celebrated the passage of the House bill in May, he also "wants a bill that has heart in it," press secretary Sean Spicer said at the White House on Tuesday.

Senate Republicans have vowed to repeal and replace key parts of the ACA, commonly known as Obamacare, the 2010 law that has provided insurance to about 20 million additional Americans through a combination of expanded Medicaid coverage and private insurance, much of which is federally subsidized.

But even among Republicans - no Democrats are expected to support the bill - competing ideological goals have complicated Senate negotiations. Among the challenges in a messy drafting process: how to lower insurance premium costs and eliminate what some view as burdensome coverage mandates without increasing the number of uninsured Americans.

The more contentious issues have included how to slow spending growth in Medicaid and reducing requirements for health plans, such as mandated coverage for certain diseases or pre-existing conditions.

Senate leaders hope to start debate by Tuesday or Wednesday of next week.

Democrats have registered their displeasure this week. On Tuesday, they continued their protests.

"If the Republicans continue down this path, ignoring the principles of transparency and the open debate that define this legislative body, we Democrats will continue to do everything we can to shine a light on what our Republican friends are doing," Senate Minority Leader Charles Schumer, D-N.Y., said.